Cannulated System for Sequential Intramedullary Cement Extraction From Humerus During Revision Shoulder Arthroplasty

Removal of the cement mantle during revision shoulder arthroplasty is often challenging. Previous techniques utilizing a humeral window or split osteotomy have been described. These techniques can be technically challenging, put the patient at risk for nonunion or fracture, and require implants or sutures for fixation. Intramedullary techniques have been described including the use of specialized osteotomes or cement splitters as well as the use of ultrasonic cement extraction devices. However, concerns related to fracture and thermal damage to neurovascular structures remain a concern. Here we describe an intramedullary technique for cement removal utilizing a cannulated system for sequential removal of the cement mantle and cement plug from within the humeral canal after the cemented implant has been removed. This technique allows for a mechanical method of efficient cement extraction that utilizes common instruments and does not require an osteotomy or window, and has a limited risk of fracture and neurovascular damage.
Source: Techniques in Orthopaedics - Category: Orthopaedics Tags: Special Technical Articles Source Type: research